Clinical parameters in male genital lichen sclerosus: a case series of 329 patients.

Background:   The dermatological aspects of male genital lichen sclerosus (MGLSc) have not received much prominence in the literature. Sexual morbidity appears under-appreciated, the role of histology is unclear, the relative places of topical medical treatment and circumcision are not established, the prognosis for sexual function, urinary function and penis cancer is uncertain and the pathogenesis has not been specifically studied although autoimmunity (as in women) and HPV infection have been mooted.

Objective:   To illuminate the above by analysing the clinical parameters of a large series of patients with MGLSc.

Matrix metalloproteinases are associated with increased blood-brain barrier opening in vascular cognitive impairment.

Background And Purpose: Subcortical ischemic vascular disease (SIVD) is a major form of vascular cognitive impairment (VCI) due to small vessel disease. Matrix metalloproteinases (MMPs) are neutral proteases that disrupt the blood-brain barrier and degrade myelin basic protein under conditions of neuroinflammation. Brain tissues and cerebrospinal fluid (CSF) of patients with VCI have increased levels of MMPs.

Psoas abscess with associated septic arthritis of the hip in infants.

We describe psoas abscess with concomitant septic hip arthritis in 2 infants, 3 and 7 months old. The common clinical features were a palpable mass in the inguinal region, irritable hip, and delayed treatment. The diagnosis of septic hip was delayed in one child, and they both had residual hip deformity at follow-up.

How displaced are "nondisplaced" fractures of the medial humeral epicondyle in children? Results of a three-dimensional computed tomography analysis.

Background: The management of fractures of the medial humeral epicondyle is controversial, but the primary issue is the relationship of outcomes to the extent of fracture displacement. This study compares the use of radiographs and three-dimensional computed tomography for determining the amount of displacement in medial humeral epicondylar injuries deemed to be minimally displaced (<5 mm) or nondisplaced.

Methods: A retrospective review was performed on the cases of all patients with a fracture of the medial humeral epicondyle that had been diagnosed as minimally displaced or nondisplaced who were seen over a one-year period at our institution.

Outcomes of extra-articular, intra-epiphyseal drilling for osteochondritis dissecans of the knee.

Background: When conservative management fails to heal femoral condyle osteochondritis dissecans (OCD) lesions in a child, then drilling of the subchondral plate below the lesion to stimulate healing may be beneficial. This study reviews the outcomes of extra-articular, intraepiphyseal drilling of OCD lesions of the knee with intact articular cartilage.

Methods: Over an 8-year period, all children, who failed at least 6 months of nonoperative management, underwent arthroscopic knee surgery and extra-articular, intra-epiphyseal drilling for their symptomatic, nondisplaced femoral condyle OCD lesions.

Anterolateral ankle impingement in adolescents: outcomes of nonoperative and operative treatment.

Background: Ankle sprains in adolescents usually resolve with conservative management but a few patients may develop ankle impingement syndrome. There have been adult studies addressing surgical treatment of this pathology, but our study evaluated the surgical management of anterolateral ankle impingement in adolescents by comparing their outcomes after nonoperative treatment and subsequent surgical intervention.

Methods: Thirteen patients (children and adolescents) diagnosed with ankle impingement by history, physical examination, and magnetic resonance imaging during a 9-year period at our institution underwent eventual arthroscopic debridement.

Predicting initial treatment failure of fiberglass casts in pediatric distal radius fractures: utility of the second metacarpal-radius angle.

Purpose: Recent literature comparing the effectiveness of above-elbow and below-elbow plaster casts appears to suggest that either cast type offers adequate immobilization for distal radius and ulna fractures. The idea that an appropriate mold placed on the cast is the most significant determinant of successful immobilization and, thereby, patient outcome has also been elucidated. The purpose of this study was to compare the effectiveness of above-elbow versus below-elbow fiberglass casts in maintaining distal radius/ulna fracture reduction and to identify factors associated with treatment failures.

Classification of proximal tibial fractures in children.

Purpose: To develop a classification system for all proximal tibial fractures in children that accounts for force of injury and fracture patterns.

Methods: At our institution, 135 pediatric proximal tibia fractures were treated from 1997 to 2005. Fractures were classified into four groups according to the direction of force of injury: valgus, varus, extension, and flexion-avulsion.

The drop toe sign: an indicator of neurologic impairment in congenital clubfoot.

Unlabelled: Nine patients presenting during infancy were identified with clubfeet and absent anterior and lateral compartment functions. We considered these to be neurogenic clubfeet. All patients had the drop toe sign: resting posture of the toes in plantarflexion and absent active dorsiflexion movement after plantar stimulation of the foot.

Using suture anchors for cervical laminoplasty: a reliable, safe, and simple technique.

Cervical spondylomyelopathy from spinal stenosis is a debilitating disease that often progresses with neurologic deficits in the upper and lower extremities. Spinal stenosis may be treated operatively with expansive open-door laminoplasty. We describe the technique of laminoplasty using suture anchors.

Subcorneal pustular dermatosis: 50 years on.

We review the key developments in our understanding of subcorneal pustular dermatosis (SCPD, also known as Sneddon-Wilkinson disease) over the past 50 years. SCPD is a rare, chronic, sterile pustular eruption that was first described by Sneddon and Wilkinson in 1956. The primary lesions are pea-sized pustules classically described as half-pustular, half-clear flaccid fluid blisters.

Percutaneous epiphysiodesis of the lower extremity: a comparison of single- versus double-portal techniques.

Background: Percutaneous epiphysiodesis can be achieved using a single-portal or a double-portal technique. This study was performed to demonstrate any differences in outcomes, especially complications, between the 2 techniques.

Methods: This was a retrospective review of cases at a single institution from 1983 to 2002 that yielded 336 children, in which 63 qualified for the study with at least 3 years of clinical follow-up.

A highly immunogenic trivalent T cell receptor peptide vaccine for multiple sclerosis.

Background: T cell receptor (TCR) peptide vaccination is a novel approach to treating multiple sclerosis (MS). The low immunogenicity of previous vaccines has hindered the development of TCR peptide vaccination for MS.

Objective: To compare the immunogenicity of intramuscular injections of TCR BV5S2, BV6S5 and BV13S1 CDR2 peptides in incomplete Freunds adjuvant (IFA) with intradermal injections of the same peptides without IFA.

Age- and sex-related variation in song-control regions in Cassin's finches, Carpodacus cassinii.

Male Cassin's finches (Carpodacus cassinii) sing long, complex songs that incorporate many elements mimicked from other species. Although one-year-old males (males in their first breeding season) are sexually competent and do breed, they sing a simpler song (fewer syllable types) than do males two or more years old (called after-second-year males). Females do occasionally sing, but with much less stereotypy and complexity than breeding males of any age.

Fatal toxic epidermal necrolysis due to lansoprazole.

Toxic epidermal necrolysis (TEN) is a serious cutaneous reaction and is most commonly drug induced. It is associated with significant morbidity and mortality. We describe a patient who developed fatal TEN after re-exposure to lansoprazole.